The Discursive Performance of the Alliance in Family Therapy: A Conversation Analytic Perspective

ANZJFT Volume 28 Number 4 2007 pp. 210–217210

Following the ‘discursive’ turn in family therapy, theattention of practitioners shifted towards understand-ing how culture and language shape meaning-makingin therapy. In this article, we demonstrate how conver-sation analysis (CA) can be used to examine theprocesses and outcomes of systemic/constructionistpractice. We used CA to study collaborative interac-tions of a renowned constructionist therapist KarlTomm and one client–family. Viewing collaboration asa pivotal aspect of the therapeutic alliance, wedemonstrate how the ‘split’ within-system allianceswere developed and sustained in the course oftherapy and how they were discursively transformedinto ‘intact’ alliances. The therapist’s efforts to alignwith perspectives of family members (and subsys-tems) seemed pivotal in this process.

Keywords: family therapy, conversational analysis, collaborativerelationships

In the mid-1980s family therapy ‘went’ postmodern. Thepostmodern critique of conventional family therapy revolvedprimarily around the issue of therapist power and influencevis-à-vis families. The proponents of postmodernism chal-lenged an instrumental, hierarchical approach to workingwith clients and advocated replacing it with a more collabora-tive, participatory engagement. What this collaborativeengagement entails has remained a matter of controversy;nonetheless, the collaborative dimension of the therapeuticrelationship has become a distinguishing feature of postmod-ern therapies and some have even used the term‘collaborative’ to refer to postmodern approaches to workingwith families (Perlesz & Brown, 2005).

Against this backdrop, we discuss a research studythat investigated the use of language in postmodern, ‘col-laborative’ therapy. Our objective in writing the article istwofold. First, we offer an exploratory account of how anavowed collaborative therapist shared his expertise ininteraction with a family in ways that acknowledged andutilised family members’ understandings and preferences.

For us, therapeutic collaboration, and therapeutic alliancemore broadly,1 is created and sustained through repeated col-laborative interactions. By observing specific examples ofcollaborative client–therapist interaction, it may be possibleto understand better how the alliance is built (or not) discur-sively, that is, in communication. Second, we introduceconversation analysis (CA), a sociological tradition of research,arguing that it has a strong potential both for investigatingtherapy as an inter-subjective and interactive endeavor, andfor offering not only a detailed account of the therapy processbut also of its outcomes.

We begin the article by providing our conceptual defini-tion of ‘collaboration’, followed by the key assumptions andpractices of CA, along with the details of this study. We con-clude with the discussion of the results of a family therapysession facilitated by Karl Tomm, MD. Tomm’s major contri-butions to the field of family therapy relate to how therapistscan use language to foster collaborative interactions with fam-ilies. By attending closely to Tomm’s communication with thefamily we hope to identify the details of interaction responsi-ble for the collaborative dimension of his work.

Traditional Definition of CollaborationThe term ‘collaboration’ derives from Latin collaborare,which means to labor together (The Oxford Paperback

The Discursive Performanceof the Alliance in Family Therapy:A Conversation Analytic Perspective

Olga Sutherland and Shari Couture

Olga Sutherland: University of Calgary,Alberta, Canada, [email protected]

Shari Couture: 5207 Baines Rd. NW, Calgary,Alberta, Canada T2L 1T9

Dictionary, 1994). ‘Collaboration’ is not the same as ‘coop-eration’, which means joining an action or operation, or ascompliance, which is yielding to the will of others.Collaborating implies sharing in production and a willingparticipation in a common effort. Interestingly, while recog-nising that collaborating involves more than one party, thetherapy literature largely reflects the unilateral conception ofcollaboration as client compliance. Most research on collab-orative engagement has focused on the degree of clients’cooperation or resistance, homework completion, andinvolvement in the client role (cf. Tryon & Winograd,2002). Traditionally, clients were expected to accommodatethe professionals’ ideas about how clients need to participatein therapy and what goals they need to pursue in order forthem to benefit from treatment. As Tryon and Winogradargue, ‘Attractive therapy patients appear to be those whohave characteristics that may enable to fill the patient role ascooperative collaborators with therapists’ (p. 112).

Collaboration ReconceptualisedWhile traditional therapy literature has focused almostexclusively on clients’ collaboration (read ‘compliance’) withtherapists’ interventions, therapists inspired by feminist,constructivist, and social constructionist traditions haveoften prioritised their collaborative positioning in relation toclients (Hoffman, 1992; Real, 1991). However, what hasbeen missing in this postmodern/poststructural perspectiveis a ‘Language to describe the client’s “collaborative stance”as a more active participant in the collaborative process’(Perlesz & Brown, 2005, p. 177). From a more encompass-ing perspective, collaboration is neither the soleresponsibility of the therapist nor the client’s willingness togo along with the therapist’s agenda, but a joint anddynamic performance (Rober, 2005).

For the purposes of this study we define collaboration as aprocess of coordinating, co-sharing, and co-creating meaningor understanding (Anderson & Goolishian, 1988;Weingarten, 1991). This fluid and interactive view of collab-oration seems to contrast starkly with more traditionalperspectives on collaboration as one’s capacity to worktogether with others, or as an inherent quality of the thera-peutic relationship (Weingarten). Our definition ofcollaboration implies that the working alliance is generatedand sustained (or not) in and through repeated collaborativeinteractions emergent from the participants’ ongoing respon-sive efforts. The alliance is something that therapists andclients create together at a specific moment. What peopleactually talk about is less important than whether each personfeels included when producing the meaning that evolves fromthat interaction. This definition places an emphasis on theworking side of the working alliance; a side that we feel hasbeen overlooked in most of the therapy literature.

From this constructionist perspective, language does notonly arise from relationships; people’s use of language alsoforms, or better, ‘performs’, those relationships (Anderson& Goolishian, 1988). This view differs from the traditional

‘representational’ conception of language as a mirror imageof some stable intrapsychic or interpersonal reality. Peopleperform or enact their relationships using available, andoften differing, cultural resources and practices for under-standing and influencing. Articulating, coordinating, andreconciling these differences at each conversational turn,may be viewed as both constituting and accounting for thequality of the therapeutic relationship.

How does the conception of collaboration as coordina-tion, co-sharing, and co-creation of meaning translate intothe practice of family therapy? Collaboration in familytherapy is not only interpersonal, the view consistent with aconstructionist perspective, but also interpersonally multilay-ered (Pinsof, 1995). Ideally, the therapist collaborates ongoals and tasks with each family member, each family subsys-tem (e.g. parental, sibling), and the family system as a whole(Pinsof & Catherall, 1986). The task of the therapist is to notstop at validating family members’ familiar, often polarisingmeanings and ways of relating; familiar meanings need to berenegotiated into more mutually acceptable lines of talk.

Bridging Systemic and Discursive PerspectivesWith family therapy’s postmodern interest in discourse (lan-guage use), the traditional systemic focus on patterns ofinteraction among family members shifted to the back-ground. We argue that systemic and discursive frameworkscan be fruitfully reconciled. We further maintain that discur-sive performance of relationships is empirically analysable.

Drawing on Strong and Tomm (2007), we see that theproblem that brings families to therapy is that the use of lan-guage within the family system is deemed objectionable byone or more family members. By ‘objectionable talk’ wesignify meanings, and ways of articulating those meanings,which recipients experience as pathologising them as individ-uals or as distorting or invalidating their experiences andperspectives (Tomm, 1991). Refraining from, imposing,rejecting, and misunderstanding meaning may be foundobjectionable (Johnson, 2004; Weingarten, 1991). Talkfound objectionable within a family may create impasses pre-venting the family from moving forward in their interactionsin preferred ways. Such pathologizing interactions occurwhen people fail to coordinate meaning to find a shared lan-guage and mutual methods of talking deemed acceptable byall parties. Not all coordination of meaning is helpful; to thecontrary, mutually objectionable meanings can be highlycoordinated. The coordination of objectionable meaning mayresult in non-mutual and ineffective meanings and the inabil-ity of family members to move forward together. Familymembers remain committed to their preferred (or familiar)ways of responding; others find those ways objectionable andrefuse to join in. Re-coordinating their talk may help alterobjectionable interactions and facilitate interactions that allfamily members would deem adequate.

A discursive understanding of coordinating objection-able meaning is highly reminiscent of what family therapistshave traditionally discussed as changing patterns in relation-

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Discursive Performance of the Alliance in Family Therapy

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ships. Traditionally these patterns were often labeled as pat-terns or cycles (e.g. pursue and withdraw), whereasdiscursively these patterns play out in the tenths of secondin the actual talk from one speaker’s turn to the next. Withthis focus on the actual talk researchers are able to investi-gate what previously has been alluded to in abstract terms(names of patterns) in concrete data grounded in actualconversation. Through a discursive lens the complexity ofmultiple first order cybernetics within systems patterns (e.g.father and son) or second order cybernetics between systemspatterns (e.g. therapist and family members) are put under amicroscope that magnifies the previously unnoticed detailsof how these patterns are accomplished.

To examine (a) how the therapist collaborated with thefamily (its members and subsystems), conceptualised byPinsof (1995) as between-system alliances, and (b) howfamily members collaborated with each others’ meaningsand preferences, or within-system alliances, we used aresearch approach of conversation analysis. Interested intherapy outcomes, we were especially attentive to how the‘split’ within-system alliances transformed over time intothe ‘intact’ alliances, and in how the therapist’s responsesinformed such transformations.

Conversation Analysis Conversatinal analysis (CA) describes people’s mundanemethods for doing social life. Through studying variousforms of talk, conversation analysts have found that anyinteraction is loosely shaped by a system of normative rulesand methods for producing one’s own actions and for recog-nizing and interpreting the actions of others (Heritage,1984). One way to structure interaction is to rely on paired

actions (question–answer, invitation–rejection or accep-tance; Sacks, 1992). Actions invite particular next kinds ofactions and so on — there is a sequential structure to inter-action. Those who produce first parts of adjacency pairs(e.g. questions) tend to keep their speaking partnersaccountable for producing conditionally relevant appropri-ate second parts (e.g. an answer or an explanation as to whythe answer is not produced). Consider the followingsegment (borrowed from Atkinson & Drew, 1979; see Table1 for CA transcription notation).

Child: Have to cut the::se Mummy(1.3)

Child: Won’t we Mummy(1.5)

Child: Won’t weMother: Yes

The child does not interpret the mother’s silence as aproblem of hearing. If this was the case, the child wouldhave presumably repeated the question, maybe stating itlouder. Instead, what we observe is the child offering moreand more truncated versions of the same question. Thechild seems to be demanding a response from the mother ina determined communicative pursuit (lines 3 and 5) untilshe offers one (line 6). The child’s actions may be viewed asdisplaying this child’s tacit understanding that the absenceof the second part of the pair is noticeable because itbreaches a norm of paired action sequences.

Conversation analysts examine turns in talk (or better,pairs of turns): how they are designed, where in interactionthey occur, how they are connected to prior turns, and whatimplication they may pose for subsequent turns. Given thatthe same utterance may be used to accomplish different

TABLE 1Transcription Notation

Symbol Indicates

(.) A pause which is noticeable but too short to measure.

(.5) A pause timed in tenths of a second.

= There is no discernible pause between the end of a speaker’s utterance and the start of the next utterance

: One or more colons indicate an extension of the preceding vowel sound.

Underline Underlining indicates words that were uttered with added emphasis.

CAPITAL Words in capitals are uttered louder than surrounding talk.

[ ] Overlap of talk.

{ } Indicates clarificatory information

? Indicates rising inflection.

! Indicates animated tone.

. Indicates a stopping fall in tone.

** Talk between * * is quieter than surrounding talk.

> < Talk between > < is spoken more quickly than surrounding talk.

{ } Non-verbals.

Bolded Researchers’ attempt to direct the reader’s attention

Note: Adopted from Sacks, Schegloff, and Jefferson (1974).

communicative actions (refusal, invitation, accusation,apology, and so on), CA researchers orient to how an actionand its function are ‘noticeably’ interpreted by its recipient.This means that the design of the next turn in talk willdisplay how the recipient made sense of the previous speak-ing turn (and what the speaker’s intentions were for thatturn). The mother in the above segment interprets thechild’s action as a case of a question because she produces ananswer (line 6). Conversely, if she produced an alternativeresponse (e.g. ‘Wow, good job’), researchers would haveused her reply as a basis for drawing conclusions about howshe might have interpreted the child’s prior turn (e.g. thechild seeking acknowledgment of an effort). Instead ofoffering a detailed description of a therapy session from anobserver’s perspective, CA provides a framework for describ-ing meaning and action from the participants’ frame ofreference (of course, shaped by researchers’ cultural, theoret-ical, and methodological biases and commitments).

The Details of the StudyThis article is a part of the larger study investigating discur-sive impasses and ‘forward moving’ conversations (Couture,2005). In the larger study, the therapist (Karl Tomm) andfamily members jointly selected a session from a series ofregularly recorded sessions. Approximately one month afterthe selected session, I (Shari Couture) interviewed the ado-lescent separately from the parents and then interviewed theparents. In both interviews, we reviewed the taped sessionin order to select moments of interaction using a form ofKagan’s (1975, see Elliott, 1985) Interpersonal ProcessRecall (IPR), a method for retrospectively reviewing video-taped therapy sequences. The adolescent and his parentswere separately asked to identify and talk about themoments in which they felt that all members of the familywere beginning to move forward in ways that positivelyeffected their interactions after the session.

Although I transcribed and analysed 35 minutes of thesession, my analysis focused in particular on segmentswhich the family had chosen in the IPR interview thatshowed conversational evidence of the progression towards aforward moving shared understanding or position in dis-course. I used a combination of analytic strategies suggestedby Have (1999), which helped me analyse the details of thetranscript to answer the question, ‘What is this participantdoing in this turn?’. The analytical process took me approxi-mately six months. To justify the rigour of the research Iattended to four considerations. First, in an attempt to gen-erate an ‘emic’ account of interaction (in the spirit of CA), Imade use of the participants’ own understandings as theydisplayed them in interaction. Second, I engaged in reflexivediscussions with various readers of the analysis in order toevaluate the plausibility or trustworthiness of my claims. Iinvited feedback from readers throughout the process aswell as enlisted seven readers to review a draft of the entireresearch document (Couture, 2005). Third, I provided richand extended transcriptions of conversations to allow future

readers to make their own judgments about my claims.Finally, I conducted a deviant case analysis, where Iincreased the validity of my claims by demonstrating howalternative practices led to alternative outcomes.2 This per-mitted a concentrated look at the conversations as Ireworked my analysis to come up with an account that fitwith all cases.

Using CA to Examine Collaboration in Family TherapyWhat follows is the description of discursive processes thatmay be viewed as accounting for the performance of objec-tionable talk and alterations in this talk. Specifically, weshow how participants in family therapy ‘talked into being’pathologising interpersonal patterns, and how they re-coor-dinated these patterns into more healing patterns.

Coordination of Objectionable TalkThe family who participated in the examined sessionincluded a father (Bob), mother (Sandra), son (Joe, 14 yearsof age), and a therapist (Karl Tomm). The session analysedwas the first one following Joe’s release from the hospitalfollowing concerns about his recent self-harming (‘cutting’)behaviors. Before leaving the hospital Joe had agreed to acontract that listed measures that he could have taken tokeep himself safe. The family members’ initial interactionscan be characterised as an entrenchment in what we havecalled a pathologising interpersonal pattern (e.g. parents’control–son’s resistance of control via disengagement;Tomm, 1991). The parents have taken a position of cer-tainty that the son will honour the contract, that is, willkeep himself safe, whereas Joe has seemed uncertain of hisability to accomplish that.

Segment 167iii Bob: …and um (3) myself (1) and I can’t speak68 for everybody else but I want to make sure (.) …69 Joe: {Joe picks up pop bottle}70 Bob: I mean I understand that the way it was is not the

way it is going71 to be in the future it is going to be totally dif-

ferent it has to be.72 (3) And I don’t know how Joe feels about that

but um (.8)73 Joe and I over the last couple of days (.6) {Looks at

Joe} we had74 a chance to talk one on one huh (.8)75 Joe: {Joe leans back and looks away from

Bob}*uhuh* (1)76 Bob: just him and me (.5)

Segment 2395 Bob: Which ones are your biggest concerns

Joe?(2.3){looking down not at Joe}396 Joe: *>don’ know<* {looking down}397 (5.6)398 Bob: {Looks up to the ceiling and pierces lips} See part

of wha[t]

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Joe and Bob seem to find each other’s talk objectionable. Asseen in the first segment, Bob articulates his position (lines 70through 74) in a straightforward or nonhesitant manner,demonstrated by few pauses or breaks in his talk, and choiceof words such as ‘totally’ or ‘it has to be’. Joe, however, onlyminimally acknowledges Bob’s position (note a ‘weak agree-ment’ in line 75, which may be considered a safe way todisagree;4 Kitzinger & Frith, 1999). Nonverbally, Joe leansback and looks away and speaks in a quiet tone of voice. Inthe second segment, Joe similarly refuses to join in, exhibitedby his ambivalent response (line 396), or what some mightcall ‘dead end’ response (e.g. ‘don’t know’ or ‘*Ya*’). Theseverbal and nonverbal messages may signal to speakers thataddressees are reluctant to join in speakers’ proposed methodsof talking and relating. However, as a speaker Bob continuesoffering his opinion (without modifying), failing to orient toand address Joe’s displayed reluctance to become involved(line 78). Bob’s talk is in some ways ‘monological’ and irre-sponsive to his son’s displayed conversational preferences.

Facilitating Between-System AlliancesNow we will show how Tomm collaborates with Joe andBob to help them re-coordinate their interactions in waysthat permit them to move forward together. We argue thatthe building of between-system alliances (e.g. between thetherapist and each client) eventually leads to the develop-ment of within-system alliances (among family members;Pinsof & Catherall, 1986). The following segment demon-strates how Tomm manages to cultivate collaboration andfoster client engagement even in the face of the adolescent’sambivalence and disengagement.5

Segment 488 Therapist: >Okay< (.7) um (1.2) now how do you feel

about this like is89 this is something you feel that you can live or

(.5) or are you not90 sure that you can live up to this or not er::

(3.4)91 Joe: >I don’t know< (.4) I don’t know yet I guess (.)92 Bob: {Bob furrows his brow}93 Therapist: Don’t know ya (1.2) well that is probably

an honest statement94 because you don’t know for sure right? (.)95 Joe: *Mhmm* (.)96 Therapist: But I guess your intention at the moment is

to try to (1.2) honour97 this (.7) agreement? (.3)98 Joe: Uhuh (1)

Tomm’s recognition of Joe’s ambivalent response (‘don’tknow’) demonstrates that he is not invested in what in thissession was an allied position with the parents — to ‘makesure he follows through with a safety contract’ (compareTomm’s response to Bob’s response in line 92). Tomm treatsJoe’s response as a legitimate answer and collaborates to co-develop Joe’s position of doubt in his ability to followthrough with the safety contract. At the same time, Tomm

tentatively offers brief, contestable invitations to a smallshift in meaning (line 94). Up until this point in thesession, Joe has developed a position of doubt in the con-tract (a position found quite objectionable by his fatherthereby inviting a further PIP). In his utterance in line 94,Tomm invites Joe to a middle ground between extreme cer-tainty (the position the father has articulated) and extremedoubt (Joe’s position so far) by suggesting that Joe doesn’tknow ‘for sure’ if he could or could not follow through withthe safety contract.

In contrast to Bob’s earlier nonhesitant talk, Tommoffers his formulations tentatively (repeated pauses andrising intonation). At many points in the session Tommuses this type of tentative formulation as he packages histalk for both Bob and Joe. In this way, he is more likely tobe heard; further, the clients at any time have a conversa-tional ‘space’ (for example, provided by pauses) to jump inand edit the therapist’s talk if it is objectionable to them. Inthe following segment Tomm is multiply-engaged (Real,1991). He discursively aligns with the positions of bothparties:

Segment 5218 Therapist: That’s great stuff (1.4) wow (.8) the following

are219 things that I still need help (.4) with from

my parents or220 others (1.2) shelter (.6) money support food

(.9)221 advice for problems (1.2) school:: life (.5)

general I guess (2.3)222 Oh! It sounds like you did a lot of work! (1)223 Bob: {Bob sits up straight with a small smile}224 Joe: *Mhmm* (.7)225 Therapist: Oh (2.4) you must feel (.) >pretty good

about< (.6) what you’ve226 done here eh? (1)227 Joe: {Joe looking down at his bottle of pop}228 Therapist: ya no? (1.5)229 Joe: *Ya* {Looking down and fiddling with

bottle}(1)230 Therapist:Or do you feel like you were kind of forced

into it? er:: (1.9)231 Joe: *Kind of* (1.4)232 Therapist:Or pushed a little bit? (.)233 Joe: Ya (1)234 Therapist:Not forced but pushed=235 Joe: =*Ya* (1.2)

In line 223 Bob nonverbally joins with Tomm’s validationof his position that the contract is a ‘great stuff ’. In lines224 and 229 Joe once again produces weak agreements tothe therapist’s suggestion (quietly mumbled ‘*Mhmm*’ aftera long pause and ‘*Ya*’). Tomm could have oriented tothese utterances as signs of agreement or avoidant strategies.Instead, he attends to these ambivalent responses to collabo-rate with Joe in developing his position of uncertainty (lines225 and 230). By setting up Joe’s reply in line 228 with so-



called ‘candidate answers’ (‘ya no?’), Tomm encouragedwhat Bangerter and Clark (2003) called an agreementresponse (‘ya’) rather than an acknowledgement response(‘uhuh’). This candidate answer invited Joe to ‘take a posi-tion’. By attending to a weak agreement and using acandidate answer, the therapist successfully encouraged Joeto develop his position rather than to withdraw meaning orto avoid taking a position. The withdrawal of meaning canbe viewed as an example of non-collaborative interactions(Weingarten, 1991), a split within-system alliance (Pinsof,1995), a part of a PIP (Tomm, 1991), or of an interactive‘cycle’ (Johnson, 2004). While inviting Joe to take a posi-tion, Tomm displays a noncommitment to what positionJoe takes; he treats Joe’s responses, previously found objec-tionable by his father, as valid and worthy of understandingand exploration. Also noteworthy is how at the end of thesegment Tomm edits his talk, based on Joe’s feedback, untilthey find shared language for describing Joe’s experience. Ina way, Tomm keeps ‘repairing’ his talk until it is until it issuitable to Joe. From the CA perspective, Joe’s experience isemergent; it is co-created on a turn-by-turn basis ratherthan the onus for the understanding of his experienceresting on Joe’s specific articulations.

To summarise, Tomm invites collaboration from familymembers by using tentative formulations (pauses, restarts,breath inhalations, and so on), selective listening, attentionto weak agreements, and subtle invitations to shifts inmeaning. We now show how these strategies worked tointroduce and anchor change in the conversations amongfamily members.

Facilitating Within-System AlliancesLater in the session, Bob and Joe began communicating inways that demonstrated they were re-coordinating theirmodes of speaking to develop mutually acceptable lines oftalk, a positive outcome evident in what they were sayingand how they were saying it:

Segment 6534 Bob: = a::nd and it was (.) I think (.) ::I think we both

kind of came up535 out of there (.3) and >Joe you can (.) speak for

yourself< but (.)536 what I came out of it was that (.1) ummm >we

need to do things537 a little bit different< (.5) we need to start (.1) >do

things a little bit538 different< and I asked you one question remem-

ber (.) what I asked? (.5)539 Joe: No {Looking down, playing with bottle, sarcastic

tone} (.9)540 Bob: You don’t remember (.3) it had to do with the

fact I said (.9) umm (.8)541 wouldn’t it be neat (.5) o::r did you like the fact

that we just sat and542 talked (.4) just talked about stuff (.) and you said

you did (1.9)

543 And I asked you if you would like to do more inthe future what’d

544 you say? (1.1)545 Joe: Sure {Solidly spoken} (2.2)546 Bob: And that is something that (.3) maybe I haven’t

done very much in547 the past? (.) >for what ever reason< (.5) but just

(.5) shoot the fat (.2)548 talk.

In the above segment Joe offers less objectionable responses(e.g. Line 545) as Bob demonstrates a very different way ofinviting his son into dialogue in efforts to co-create more‘healing’ interactions. Having observed the outcomes ofTomm’s ‘dialogical’ engagement with Joe, Bob eventuallymodifies his talk in ways that resemble Tomm’s talk. Facedwith a dead end response (line 539), instead of abandoningdialogue with his son (as seen in segment 2) or imposing hismeanings (as seen in segment 1), Bob continues to work atinviting Joe into conversation, something Tomm haddemonstrated previously. Bob begins to treat Joe’s responsesas legitimate, which enables them to continue in dialogue.He follows up ‘No’ by saying, ‘You don’t remember’,marking the previous utterance as a valid response. Hefurther redesigns his question in line 540. Instead of aban-doning talk when it becomes labored, Bob works to repairprevious breakdowns by continuously editing his talk. Bobbegins to carefully package his question (lines 543 and 544)to bridge his talk with that of his son’s. This careful con-struction of his question is evident in the pauses and verbaltokens ‘(.9) umm (.8)’ in line 540 and his self-correction ofthe content of the question in line 541 (‘wouldn’t it be neat(.5) o::rr did you like …’). In addition, instead of simplyanswering for Joe, Bob invites Joe to join him in line 544(‘what’d you say?’). He further presents his perspective as hisand contestable rather than as absolute and unchangeable(lines 535–536) and uses the ‘we’ pronoun to convey soli-darity. Bob makes use of these collaborative devices toengage Joe in this conversation. His shift from an insistentto a tentative turn design helped to re-coordinate their talkand to move towards more healing interpersonal patterns.

Not surprisingly, Joe responds with a rare instance ofaccepting his father’s invitation into dialogue. In contrast totheir previous labored interaction, in line 545 Joe offers asolidly spoken uptake illustrating an increased commitmentto attempt to progress with his father. Bob accepts andextends Joe’s emergent engagement, which assists them bothin moving forward.

ConclusionAlliance building is a foundational concept in psychother-apy (Bordin, 1994) and one of the most robust predictors oftherapeutic outcomes (Horvath & Symonds, 1991). Infamily therapy, however, forming alliances with familymembers becomes a very complex task simply because ofthe number of people involved (Pinsof & Catherall, 1986).With this emphasis on the importance and difficulty of

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alliance building, details of how therapists and familymembers develop alliances in therapeutic conversations arevaluable. We argue in favor of thoroughly examining theevolving, interweaving discursive contributions of both thetherapist and the client so as to generate an adequate accountof what it means to collaborate or be aligned in therapy.

This research constitutes a bridging of systemic and dis-cursive frameworks by highlighting how relationshippatterns are performed discursively turn-by-turn.Specifically, we offered a preliminary account of how thesplit within-system alliances were developed and sustainedin the course of therapy and how they eventually trans-formed into intact alliances. Family therapists tend tounderstand interpersonal patterns or family structures assustaining problems or, if changed, as transforming families.However, a pattern or structure cannot facilitate change;rather, people facilitate change as they interact with oneanother. Instead of focusing on changing patterns, as if pat-terns exist and can produce change, family members andtherapists can focus on participating in conversations innew ways in order to change problematic interactions.Strong and Tomm (2007) suggest that problems arise whencertain discursive actions become inadequate or objection-able in developing acceptable relational coordinations. KarlTomm helped this family (in the transcriptions above) toreplace formerly inadequate understandings and communi-cations with methods that promote more acceptablerelational coordinations. By inviting family members tocoordinate their ways of talking differently, Tomm helpedthem further stabilise these as more satisfactory coordina-tions so that they could use them in conversations beyondthe session.

In this article we suggested that it is possible to examineinterpersonal patterns (Tomm, 1991) or interactive ‘cycles’(e.g. criticism/defensiveness; Johnson, 2004) as speakersperform and reform these cycles in dialogue. We furtherargued that CA can distinctly highlight processes implicatedin the collaborative co-construction by therapists and clientsof new forms of discursive activity. Scant attention is givento the linguistic means responsible for change in familytherapy. We explored the use of language in family therapyshowing how family members were talked through theirproblems effectively and collaboratively.

AcknowledgmentsSpecial thanks to Tom Strong: Funding for this study wasmade possible by the Social Sciences and Humanities,Research Council of Canada

Endnotes1 Collaboration has been commonly defined as the collabo-

rative relationship between the client and the therapist(Pinsof, 1994). Some have argued that the alliance alsoincludes the affective bond dimension (Bordin, 1994).Although collaboration and the affective bond influence

each other, we decided to delimit the study to the analysisof collaborating and to exclude the emotional bondingdimension of the alliance. That being said, we will treatthe terms ‘collaboration’ and ‘alliance’ interchangeably

2 For examples please see Couture (2005).3 This segment is one part of the 35-minute section of the

session that was transcribed. The line numbers reflect thelocation in the full transcript.

4 However, keeping with CA one would interpret theintention of each action by looking to how these actionplayed out in the current interaction.

4 Candidate answers are more commonly called multiplechoice answers.

5 The interactions show in this article focus on Bob andJoe because as seen in the larger study (Couture, 2005)Sandy was not a strongly misaligned with her son Joe.

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‘“Do you want to be bored to death or gored to death?”That’s what the psychiatrist said to me.Why don’t you speak to me like that?’Clever-sounding words:does the specialist think in rhyme? I ask myself.

An erudite man who’s become fond of meas I see him through the aftermathof assaults, kidnapping, rape: gored— not yet to death.Semi-recovered, is bored the wordfor how he is, the blankness of his days?

He’s no matadoryet I predict he will returnto that arena, the war-torn countryhowever I speak to him:it’s where he’s known love.

Choices

Helen Pavlin

Documents

The Discursive Performance of the Alliance in Family Therapy: A Conversation Analytic Perspective